Circulation, Vol 78, 621-629, Copyright © 1988 by American Heart Association
G Keren, EH Sonnenblick and TH LeJemtel
The dynamics between mitral anulus motion, and, thus, motion of the base of
the heart, and filling of the left atrium and ventricle were studied by
Doppler echocardiography in 12 normal subjects and 28 patients with dilated
cardiomyopathy. The normal motion of the mitral anulus is associated with
two phases of inflow from the pulmonary veins. The first phase (J) of
pulmonary venous inflow occurs during ventricular systole, concomitant with
the descent of the mitral anulus toward the ventricular apex, the extent of
which is 12.8 +/- 1.4 mm. The end of the descent of the anulus occurs at
the cessation of aortic ejection. About 100 msec later, a rapid recoil of
the mitral anulus toward the atrium coincides with the onset of transmitral
filling. This rapid recoil contributes to the displacement of blood from
the atria into the ventricles in early diastole. The second phase (K) of
pulmonary venous flow begins in early diastole, with its peak occurring
about 50 msec after the peak of transmitral flow. During atrial
contraction, the mitral anulus moves slightly (2.4 +/- 0.7 mm) toward the
atrium and then returns toward its initial position within 120 msec. This
motion coincides with the A wave of transmitral flow. In patients with
dilated cardiomyopathy, pulmonary venous flow and mitral anulus motion are
markedly altered in comparison with normal subjects. In all patients,
motion of the mitral anulus is either reduced or absent.(ABSTRACT TRUNCATED
AT 250 WORDS)
ARTICLES
Mitral anulus motion. Relation to pulmonary venous and transmitral flows in normal subjects and in patients with dilated cardiomyopathy
Department of Medicine, Albert Einstein College of Medicine, Bronx, NY 10461.
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